Is POSITIVE OUTCOMES, INC. flagged for Medicaid fraud?

POSITIVE OUTCOMES, INC. (NPI: 1770624348) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does POSITIVE OUTCOMES, INC. bill Medicaid?

POSITIVE OUTCOMES, INC. received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Technician, Personal Care Attendant provider. Located in SOCORRO, NM.

What is NPI 1770624348?

NPI 1770624348 is the National Provider Identifier for POSITIVE OUTCOMES, INC.. They are a Technician, Personal Care Attendant provider based in SOCORRO, NM. This NPI is registered with the CMS NPI Registry.

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POSITIVE OUTCOMES, INC.

Technician, Personal Care Attendant·SOCORRO, NM·NPI: 1770624348Share

Compared to Technician, Personal Care Attendant Peers

Total spending distribution among 5 providers in this specialty

P25MedianP75P90

This provider's total spending of $46.2M is at the below 25th percentile among 5 Technician, Personal Care Attendant providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$46.2M

$46,223,148

Total Claims

200K

Beneficiaries

51K

3.9 claims/patient

Avg Cost/Claim

$231

Monthly Spending Trend

Yearly Spending

2018

$5.8M

-2%

2019

$5.7M

+15%

2020

$6.5M

+6%

2021

$6.9M

+6%

2022

$7.3M

+0%

2023

$7.3M

-8%

2024

$6.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 11 distinct procedure codes. The top code (99509 (Home visit, assistance w/ ADLs)) accounts for 74% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

99509Home visit, assistance w/ ADLsSee all providers →

$34.1M

85K claims

$402.65

$51.71

7.8×

Top 5%

99509Top 5%

Home visit, assistance w/ ADLs

$34.1M

85K claims · 73.7%

Your Cost: $402.65/claim|Median: $51.71

7.8× median

T1019Personal care services, per 15 minSee all providers →

$5.1M

72K claims

$70.76

$82.47

0.9×

Normal range

T1019Normal range

Personal care services, per 15 min

$5.1M

72K claims · 11.1%

Your Cost: $70.76/claim|Median: $82.47

0.9× median

G9006Coordination of long-term care services, per hourSee all providers →

$4.4M

20K claims

$214.97

$204.93

1.0×

Normal range

G9006Normal range

Coordination of long-term care services, per hour

$4.4M

20K claims · 9.5%

Your Cost: $214.97/claim|Median: $204.93

1.0× median

T1027Family training and counseling, per 15 minutesSee all providers →

$1.7M

16K claims

$101.94

$53.00

1.9×

Top 25%

T1027Top 25%

Family training and counseling, per 15 minutes

$1.7M

16K claims · 3.6%

Your Cost: $101.94/claim|Median: $53.00

1.9× median

T2023Community transition, waiver; per serviceSee all providers →

$740K

3,914 claims

$188.97

$300.13

0.6×

Normal range

T2023Normal range

Community transition, waiver; per service

$740K

3,914 claims · 1.6%

Your Cost: $188.97/claim|Median: $300.13

0.6× median

S5110Home care training, family; per 15 minSee all providers →

$148K

792 claims

$187.07

$74.36

2.5×

Top 10%

S5110Top 10%

Home care training, family; per 15 min

$148K

792 claims · 0.3%

Your Cost: $187.07/claim|Median: $74.36

2.5× median

97110Therapeutic exercises, each 15 minSee all providers →

$81K

1,399 claims

$58.24

$24.49

2.4×

Top 25%

97110Top 25%

Therapeutic exercises, each 15 min

$81K

1,399 claims · 0.2%

Your Cost: $58.24/claim|Median: $24.49

2.4× median

H2000Comprehensive multidisciplinary evaluationSee all providers →

$12K

15 claims

$774.84

$114.71

6.8×

Top 1%

H2000Top 1%

Comprehensive multidisciplinary evaluation

$12K

15 claims · 0.0%

Your Cost: $774.84/claim|Median: $114.71

6.8× median

97140Manual therapy techniques, per 15 minutesSee all providers →

$8K

283 claims

$28.80

$16.79

1.7×

Top 25%

97140Top 25%

Manual therapy techniques, per 15 minutes

$8K

283 claims · 0.0%

Your Cost: $28.80/claim|Median: $16.79

1.7× median

97530Therapeutic activities, each 15 minSee all providers →

$3K

53 claims

$55.12

$33.11

1.7×

Normal range

97530Normal range

Therapeutic activities, each 15 min

$3K

53 claims · 0.0%

Your Cost: $55.12/claim|Median: $33.11

1.7× median

S9999 See all providers →

$920

56 claims

$16.43

$5.38

3.1×

Top 25%

S9999Top 25%

$920

56 claims · 0.0%

Your Cost: $16.43/claim|Median: $5.38

3.1× median

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